Treatment of disulfiram-like reactions

Under normal circumstances, ethanol in alcoholic beverages will be oxidized by ethanol dehydrogenase to acetaldehyde, which will be oxidized to acetic acid under the action of acetaldehyde dehydrogenase and discharged from the body, but certain drugs or disulfiram-like substances will prevent the activity of acetaldehyde dehydrogenase, so acetaldehyde cannot be further oxidized to acetic acid by acetaldehyde dehydrogenase, resulting in a large accumulation of acetaldehyde in the body, causing symptoms of acetaldehyde poisoning, called disulfiram reaction. After the occurrence of disulfiram-like reaction, the patient should be immediately monitored by cardiac electrodes, administered oxygen, given a small amount of sedative drugs if necessary, placed in shock position, i.e., lower limbs elevated 15-20 degrees, head elevated 20-30 degrees, in V-shaped position, given open intravenous access, rapid rehydration, and given a small amount of glucocorticoid therapy if necessary. Naloxone can relieve the symptoms of alcohol intoxication and promote the decomposition of alcohol, so it can be given to patients with disulfiram reaction. For patients with nausea, vomiting and other gastrointestinal symptoms, symptomatic treatment with drugs such as gastrofacial can also be given, and if necessary, patients should be given vasoactive drugs to maintain blood pressure, such as commonly used dopamine, m-hydroxylamine, norepinephrine, etc.